Shyam Raj Upreti1, Santosh Gurung2, Minal Patel3, Sameer M Dixit4, L Kendall Krause5, Geeta Shakya6, Kathleen Wannemuehler7, Rajesh Rajbhandari8, Rajendra Bohara9, W William Schluter10. 1. Child Health Division, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal. Electronic address: drshyam@hotmail.com. 2. Expanded Programme on Immunization, World Health Organization, PO Box 108, United Nations House, Kathmandu, Nepal. Electronic address: gurungs@searo.who.int. 3. Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States. Electronic address: hgo9@cdc.gov. 4. Center for Molecular Dynamics Nepal, GPO Box 21409, Kathmandu, Nepal. Electronic address: s.dixit@cmdn.org. 5. Expanded Programme on Immunization, World Health Organization, PO Box 108, United Nations House, Kathmandu, Nepal. Electronic address: kendallkrause@gmail.com. 6. National Public Health Laboratory, Department of Health Services, Ministry of Health and Population, Kathmandu, Nepal. Electronic address: geeta.nphl@gmail.com. 7. Global Immunization Division, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30329, United States. Electronic address: kpw9@cdc.gov. 8. Center for Molecular Dynamics Nepal, GPO Box 21409, Kathmandu, Nepal. Electronic address: r.rajbhandari@cmdn.org. 9. Expanded Programme on Immunization, World Health Organization, PO Box 108, United Nations House, Kathmandu, Nepal. Electronic address: boharar@SEARO.WHO.INT. 10. Expanded Programme on Immunization, World Health Organization, PO Box 108, United Nations House, Kathmandu, Nepal. Electronic address: schluterw@wpro.who.int.
Abstract
BACKGROUND: In Nepal, an estimated 2-4% of the population has chronic hepatitis B virus (HBV) infection. To combat this problem, from 2002 to 2004, a national three dose hepatitis B vaccination program was implemented to decrease infection rates among children. The program does not currently include a birth dose to prevent perinatal HBV transmission. In 2012, to assess the impact of the program, we conducted a serosurvey among children born before and after vaccine introduction. METHODS: In 2012, a cross-sectional nationally representative stratified cluster survey was conducted to estimate hepatitis B surface antigen (HBsAg) prevalence among children born from 2006 to 2007 (post-vaccine cohort) and among children born from 2000 to 2002 (pre-vaccine cohort). Demographic data, as well as written and oral vaccination history were collected. All children were tested for HBsAg; mothers of HBsAg positive children were also tested. Furthermore, we evaluated the field sensitivity and specificity of the SD Bioline HBsAg rapid diagnostic test by comparing results with an enzyme immunoassay. RESULTS: Among 2181 post-vaccination cohort children with vaccination data by either card or recall, 86% (95% confidence interval [CI] 77-95%) received ≥ 3 hepatitis B vaccine doses. Of 1200 children born in the pre-vaccination cohort, 0.28% (95% CI 0.09-0.85%) were positive for HBsAg; of 2187 children born in the post-vaccination cohort, 0.13% (95% CI 0.04-0.39%) were positive for HBsAg (p=0.39). Of the six children who tested positive for HBsAg, two had mothers who were positive for HBsAg. Finally, we found the SD Bioline HBsAg rapid diagnostic test to have a sensitivity of 100% and a specificity of 100%. CONCLUSIONS: This is the first nationally representative hepatitis B serosurvey conducted in Nepal. Overall, a low burden of chronic HBV infection was found in children born in both the pre and post-vaccination cohorts. Current vaccination strategies should be continued.
BACKGROUND: In Nepal, an estimated 2-4% of the population has chronic hepatitis B virus (HBV) infection. To combat this problem, from 2002 to 2004, a national three dose hepatitis B vaccination program was implemented to decrease infection rates among children. The program does not currently include a birth dose to prevent perinatal HBV transmission. In 2012, to assess the impact of the program, we conducted a serosurvey among children born before and after vaccine introduction. METHODS: In 2012, a cross-sectional nationally representative stratified cluster survey was conducted to estimate hepatitis B surface antigen (HBsAg) prevalence among children born from 2006 to 2007 (post-vaccine cohort) and among children born from 2000 to 2002 (pre-vaccine cohort). Demographic data, as well as written and oral vaccination history were collected. All children were tested for HBsAg; mothers of HBsAg positive children were also tested. Furthermore, we evaluated the field sensitivity and specificity of the SD Bioline HBsAg rapid diagnostic test by comparing results with an enzyme immunoassay. RESULTS: Among 2181 post-vaccination cohort children with vaccination data by either card or recall, 86% (95% confidence interval [CI] 77-95%) received ≥ 3 hepatitis B vaccine doses. Of 1200 children born in the pre-vaccination cohort, 0.28% (95% CI 0.09-0.85%) were positive for HBsAg; of 2187 children born in the post-vaccination cohort, 0.13% (95% CI 0.04-0.39%) were positive for HBsAg (p=0.39). Of the six children who tested positive for HBsAg, two had mothers who were positive for HBsAg. Finally, we found the SD Bioline HBsAg rapid diagnostic test to have a sensitivity of 100% and a specificity of 100%. CONCLUSIONS: This is the first nationally representative hepatitis B serosurvey conducted in Nepal. Overall, a low burden of chronic HBV infection was found in children born in both the pre and post-vaccination cohorts. Current vaccination strategies should be continued.
Authors: Belinda G O'Sullivan; Heather F Gidding; Matthew Law; John M Kaldor; Gwendolyn L Gilbert; Gregory J Dore Journal: Aust N Z J Public Health Date: 2004-06 Impact factor: 2.939
Authors: Z Y Xu; S C Duan; H S Margolis; R H Purcell; P Y Ou-Yang; P J Coleman; Y L Zhuang; H F Xu; S G Qian; Q R Zhu Journal: J Infect Dis Date: 1995-01 Impact factor: 5.226
Authors: Ali Amini; Olivia Varsaneux; Helen Kelly; Weiming Tang; Wen Chen; Debrah I Boeras; Jane Falconer; Joseph D Tucker; Roger Chou; Azumi Ishizaki; Philippa Easterbrook; Rosanna W Peeling Journal: BMC Infect Dis Date: 2017-11-01 Impact factor: 3.090